Pdf antrochoanal polyps acp are benign lesions that arise from the mucosa of the maxillary sinus, grow into the maxillary sinus and reach the. Antrochoanal polyps acps are benign polypoid lesions originating from the mucosa of the maxillary sinus, passing through the maxillary sinus. Antrochoanal polyp article about antrochoanal polyp by. Endoscopic sinus surgery for antrochoanal polyp using co2. Clinical and radiological study of antrochoanal polyps ijcmr. The objective of our study is to assess etiological and associated features of acps, and outcome following surgical treatment.
Acps are almost always unilateral, although bilateral acps have been reported in literature 5, 6. There are various surgical methods described in the literature for the removal of antrochoanal polyp that are refractory to medical treatment. The term sinonasal polyp usually refers to outgrowths of tissue into the nasal cavity. Ct scan can show the full extent of the polyp, which may not be fully appreciated with physical examination alone. The patient usually presents with unilateral nasal obstruction. Clinical presentation and the role of powered endoscopic polypectomy article pdf available in asian journal of surgery 271. Usually, it presents as a unilateral polyp arising in the maxillary sinus, most often on the posterior wall and then expands into the nasal cavity. It arises from the antrum of the maxillary sinus and passes through the sinus ostium into the nasal cavity, choana and.
Nasal obstruction and nasal drainage are the most common presenting symptoms. Antrochoanal polyp removal procedure accounted for 21. Antrochoanal polyps acp are solitary sinonasal polyps that arise within the maxillary sinus. The authors successfully treated the antrochoanal polyp with turbinoethmoidal osteoma by endoscopic sinus surgery. Acps usually have two components and these are the cystic and solid polypoid parts 14. It originates from a hypertrophy of the mucous membrane of. It further widens the antrum and reaches the nasal cavity and expands posteriorly to the choana. Antrochoanal polyp displacing the uvula and the soft palate. Surgery is the usual treatment for antrochoanal polyps. Macroscopically, the antrochoanal polyp is composed usually of three part. Functional endoscopic sinus surgery fess and powered instrumentation during fess for complete removal of acps are extremely safe and. Microphotographs of excised polyp tissue patient 1. The nasal cavity is therefore extended posteriorly into the nasopharynx through the posterior chonae.
Evaluation and management of antrochoanal polyps as a case. Discussion antrochoanal polyp, which is also known as killians polyp is a benign solitary lesion with a mucin density. A solid polypoid lesion seen in adolescent males, which arises in the maxillary antrum but typically presents as a nasal cavity mass, secondarily involving the nasal cavity as it extends through the ostium via a long pedicle. Antrochoanal polyp synonyms, antrochoanal polyp antonyms. Antrochoanal polyp concomitant with turbinoethmoidal.
In the pediatric population, the most common symptoms of an antrochoanal polyp are nasal obstruction and discharge. Similar, less common, polyps can arise in the sphenoid sinus extending into the nasopharynx. The general rule to follow in nasal pathology is to intervene as extensive as required and as limited as possible. A unilateral nasal polyp should raise the suspicion of an inverted papilloma or tumor in adults, or of dermoid cysts, encephaloceles, and gliomas in children. Antrochoanal polyp is a clinically distinct variant of sinonasal inflammatory polyp. Grossly the antrochoanal polyp is a large, solitary, graywhite, smooth polyp with a stalk of variable length. Appearance of an antrochoanal polyp behind the uvula and the soft palate. A large polyp could be seen protruding into the middle turbinate. To investigate the length of followup needed to detect recurrence of antrochoanal polyps.
By searching published articles in the pubmed database, using keywords antrochoanal polyp for the ten year period october 2004 july 2014, 74 articles were found which contain terms nasal, choanal and antrochoanal polyp in their headlines. Antrochoanal polyps acp are also known as killian polyps a er gustav killian, the doctor who stressed this special type of polyp from the maxillary antrum to choana in. Macroscopically, the antrochoanal polyp is usually com posed of a cystic part filling the maxillary sinus and a solid fig. Purpose the antrochoanal polyp acp, otherwise known as the killain polyp, is a benign lesion that originates from maxillary sinus mucosa, extending. Posterior rhinoscopy may reveal a globular mass filling the choana or the nasopharynx differences between antrochoanal and ethmoidal polypi. Many of the antrochoanal polyps appear to arise from a small area of mucosa on the posterior superior wall of the affected antrum. Twelve children and adults underwent the surgical procedure. The following medical conditions are some of the possible causes of antrochoanal polyp. Antrochoanal polyp was described by professor gustav killian, in 1906, giving a specificity among polyposis. This photograph of the medial wall of the maxillary sinus shows the widened ostium through which the. Introduction antrochoanal polyp acp is a benign inflammatory lesion that arises from the mucosa of the maxillary sinus antrum. A provisional diagnosis of antrochoanal polyp was made and the mass excised completely under endoscopic guidance.
All but one patient was treated by endoscopicsinus. Cases were monitored in terms of postsurgical complications and recurrence. Antrochoanal polyp is a benign solitary polypoidal lesion arising from the maxillary sinus antrum causing opacification and enlargement of antrum radiologically without any evidence of bone destruction. In the nasal part, the polyp was covered by ciliated pseudostratified. Rhinoscopic clinic by ear, nose and throat journal. The radiographic and ct findings in this condition have also been well described 1, 2, 3, 5. Polyp is edematous mucosa due to repeated inflammation which is protruded from nasal sinus labyrinth. In children, it constitutes 33% of all nasal polyps. The mucosal continuity between the antrochoanal polyp and the osteoma was identified. Histological analysis of the polyps showed them to be of benign inflammatory origin. It originates from a hypertrophy of the mucous membrane of the maxillary sinus antrum. Endoscopic removal of the antral and choanal portions of an antrochoanal polyp. Antrochoanal polyp is a benign polypoid lesion arising from the oedematous mucosa of the maxillary sinus and extending through the maxillary ostium into the nose. Endoscopic management of paediatric antrochoanal polyp.
The socalled antrochoanal polyp, rising from the antral mucosa, has appeared to be clinically different in character from the usual nasal polyp although grossly similar in appearance. The antral part is removed through a caldwell luc antrostomy, inferior meatal antrostomy, or middle meatal antrostomy. Histopathology introduction antrochoanal polyp arises from maxillary sinus, passes through the sinus ostia to the choana. The antrochoanal polyp is an inflammatory nasal polyp found more frequently in children than adults. Antrochoanal polyp acp is a benign solitary polypoid lesion affecting mainly adults and rarely children. However, these methods fail to restore and maintain the optimal physiology of the nose thus reducing the quality of life post. Ethmoidal polyps are usually smaller and multiple while antrochoanal polyps are usually single and larger. Evaluation and management of antrochoanal polyps ncbi. The current treatment of antrochoanal polyp is simple avulsion of the nasal part with or without removal of the antral part.
Antrochoanal or sphenochoanal polyps refer to polyp growths that originate in the maxillary sinuses. However, antrochoanal polyps are more common in children comprising onethird of all polyps in this population. Often the choanal polyp is the only example of polypoid change occurring on either side of the nose, and, not infrequently, when the affected antrum is opened the stalk of the polyp is the only evidence of such change in the mucosa. Nasal obstruction is the main symptom of these patients.
Nasal and antrochoanal polyp endoscopic resection sample. In this video, we are going to see about antrochoanal polyp. In the case presented in this paper, the polyp of 16 cm probably represents the longest giant antrochoanal polyp extirpated completely and without. Appearance of an antrochoanal polyp behind the uvula an. Antrochoanal polyp harboring cholesterol granuloma. Then, using the xomed shaver, this polyp was taken down beginning inferiorly and extending back toward the middle meatus and then the antrostomy.
Endoscopic sinus surgery procedure using co 2 laser andor microresector for paediatric and adult chronic sinusitis with antrochoanal polyp acp, with longterm followup, was examined. The antrochoanal polyps acp were removed using functional endoscopic sinus surgery fess which achieved complete cure. They occur more commonly in children and young adults, and they are almost always unilateral. Computed tomography images, showing features consistent with an antrochoanal polyp. Antrochoanal definition of antrochoanal by medical. In this study, endoscopic surgery was performed in 22. Inflammatory patterns of antrochoanal polyps in the pediatric age. Endoscopic transnasal surgery in antrochoanal polyp jama.
Examination of the oral cavity may show polyps behind the free margin of the soft palate in cases of antrochoanal polyps or postnasal drips that are related to. Antrochoanal polyp definition of antrochoanal polyp by. Antrochoanal polyps have been known about for some time. Nasal polyps usually are manifested after the age of 20 years, with affected men outnumbering women two to one. Antrochoanal polyp displacing the uvula and the soft. Datafromthreewell documented series 57 indicate that about 71% of patients with antrochoanal polyps are1039years of age. A retrospective investigation was performed on patients who had been operated on with a preoperative diagnosis of antrochoanal polyps in chiang mai university hospital from 2006 to 2012. As the antrochoanal polyp grows posteriorly, it may be missed on anterior rhinoscopy.
Endoscopic removal of the antral and choanal portions of. Polyp is edematous mucosa due to repeated inflammation which is protruded. Pdf the antrochoanal polyp, a benign solitary polypoid lesion, usually. Health, general nasal polyps care and treatment diagnosis. It represents up to 42% of all nasal polyps in children and 46% in adults. An antrochoanal polyp acp is a benign polypoid lesion originating from the maxillary sinus and extending to the choana. Polyps are noncancerous tumors that usually grow in the lining tissues of a specific organ i. They pass to the nasopharynx through the sinus ostium and posterior nasal cavity, enlarging the latter two. It represents 46% of all nasal polyps and is usually unilateral 1. Clinical presentation and the role of powered endoscopic polypectomy safe and effective. Antrochoanal polyps antrochoanal or sphenochoanal polyps refer to polyp growths that originate in the maxillary sinuses. Removal by combined approachcaldwel luc and fess large antrochoanal polyp extending upto oropharynx fess and caldwel luc approach antrochoanal polyps acp are non allergic benign polyp, which arises from the maxillary sinus, go through its ostium and extends all the way to the ipsilateral choana. This video depicts an endoscopic view of an antrochoanal polyp arising from the maxillary sinus. The use of powered instrumentation dur ing endoscopic sinus surgery has recently been described as an effective technique for removing acps from the nasal cavity.
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